[Overview of adaptive radiotherapy in 2019: From implementation to clinical use]. / État des lieux de la radiothérapie adaptative en 2019 : de la mise en place à l'utilisation clinique.

Intensity modulated radiotherapy combined with image guided radiotherapy has led to increase the precision of external beam radiotherapy. However, intra or inter-fraction anatomical variations are frequent during the treatment course and can cause under-dosing of the target volume and/or over-dosing of the organs at risk. Several adaptive radiotherapy (ART) strategies can be defined to compensate these anatomical variations. The purpose of this article is to provide an overview of available ART strategies: offline, online, hybrid (library of treatment plans) or in real-time, while considering the arrival of MR-Linac devices in radiotherapy departments. The tools required to these ART strategies such as auto-segmentation, deformable image registration, calculation of the daily dose or dose accumulation, are also described. Implementing an ART strategy requires a rigorous quality assurance process, at each stage and on the entire workflow, as well as prior organization and training from of all the trades. A strong multidisciplinary involvement is finally required in order to ensure ART treatments.

A Novel Method for the Metallization of 3D Silicon Induced by Metastable Copper Nanoparticles.

The development of efficient copper deposition processes in high-aspect-ratio silicon structures is still a key technological issue for the microelectronic industry. We describe here a new process for the deposition of copper thin films in three-dimensional (3D) structures induced by the decomposition of a copper amidinate precursor in solution under a moderate H2 pressure. The reduction of a metal precursor under soft conditions (3 bar, 110 °C) affords the preparation of a high-purity, conformal metallic layer. We unveil a novel deposition mechanism driven by colloidal copper nanoparticles (NPs) in solution that behave as a reservoir of metastable metallic NPs that eventually condense as a solid film on all immersed surfaces. The film growth process is characterized by time-resolved analyses of the NPs in the colloidal state (nuclear magnetic resonance NMR and UV-vis spectra) and of the NPs and metallic layer on substrates (transmission electron microscopy TEM, and scanning electron microscopy SEM). Major deposition stages of this process are proposed and the conformal metallization of 3D silicon substrates is successfully achieved. This method is transposable to other metallic layers such as silver or nickel.

[Impact of dynamic IMRT and tomotherapy in pelvic cancers: a prospective dosimetric study with 51 patients]. / Apport de la RCMI rotationnelle et de la tomothérapie hélicoïdale dans les cancers pelviens : étude dosimétrique prospective sur 51 patients.

PURPOSE: To compare the dosimetric results of different techniques of dynamic intensity modulated radiation therapy (IMRT) in patients treated for a pelvic cancer with nodal irradiation. PATIENTS AND METHODS: Data of 51 patients included prospectively in the Artpelvis study were analyzed. Thirty-six patients were treated for a high-risk prostate cancer (13 with helical tomotherapy, and 23 with Rapid'Arc(®)) and 15 patients were treated for a localized anal cancer (nine with helical tomotherapy and six with Rapid'Arc(®)). Plan quality was assessed according to several different dosimetric indexes of coverage of planning target volume and sparing of organs at risk. RESULTS: Although some dosimetric differences were statistically significant, helical tomotherapy and Rapid'Arc provided very similar and highly conformal plans. Regarding organs at risk, Rapid'Arc(®) provided better pelvic bone sparing with a lower non-tumoral integral dose. CONCLUSION: In pelvis cancer with nodal irradiation, Rapid'Arc and helical tomotherapy provided very similar plans. The clinical evaluation of Artpelvis study will verify this equivalence hypothesis.

[French radiotherapy database: results of a survey of French radiation oncology centers in 2007]. / Observatoire national de la radiothérapie: rapport de l'enquête conduite en 2008 sur l'année 2007.

For the second year, the French Radiotherapy Database presents information from French radiation oncology centers. Among 179 centers, 159 have participated (90 %). The number of accelerators increased from 371 to 384 between 2006 and 2007, 11 % of these machines are more than 15 years old. On average, centers are open 50 hours per week for treatment and 9.5 % more for maintenance. The lack of dedicated CT remains a difficulty: 158 from 159 centers have an access to a CT, but only 50 % have a dedicated scanner. There is no progress compared to 2006. The proportion of centers having a MU double calculation system has increased from 51 to 58 %. Two thirds of centers do not implement in vivo dosimetry. The activity is stable around 190 000 treatments per year. Three-dimension conformal radiotherapy is used for more than half of treatments in 77.2 % of private centers and 50 % of public hospitals. Intensity modulated radiotherapy remains rarely used. The number of radiation oncologists and technologists remains stable. The number of radiophysicists has increased from 7.6 %. Despite some progress, the difficulties of this speciality persist in France and are equally distributed across all regions, and between private and public centers. In 2009, the French Society for Radiation Oncology and the associated partners will continue this survey, which interest is recognized by both professionals and health administrations.

[Pediatric thoracic spine radiographs: Comparison of two scintillators]. / Radiographies thoraciques pédiatriques: comparaison de deux détecteurs à mémoire.

PURPOSE: To compare image quality and radiation exposure from pediatric thoracic spine radiographs from two systems, one using a granular structure scintillator and another using a needle structure scintillator with 40% reduction of exposure. PATIENTS AND METHODS: Randomized prospective study of 296 patients divided into 2 groups of 5 weight categories from 4 to 60 kg. Standard technique parameters are used for granular structure scintillators with dose reduction of 40% applied for needle structure scintillators based on results from a phantom study. Image quality based on detectability of 8 anatomical structures for both types of scintillators was assessed by 6 blinded radiologists. Exposure was expressed by DLP. Results underwent statistical analysis. RESULTS: Overall, image quality was superior with corresponding dose reduction between 33-46% according to weight with needle structure scintillators. For the 4 lower weight categories, image quality was identical. CONCLUSION: With image quality at least equal, new needle structure scintillator units allow a dose reduction of about 40%.

Synthesis of tin and tin oxide nanoparticles of low size dispersity for application in gas sensing.

Nanocomposite core-shell particles that consist of a Sn0 core surrounded by a thin layer of tin oxides have been prepared by thermolysis of [(Sn(NMe2)2)2] in anisole that contains small, controlled amounts of water. The particles were characterized by means of electronic microscopies (TEM, HRTEM, SEM), X-ray diffraction (XRD) studies, photoelectron spectroscopy (XPS), and Mossbauer spectroscopy. The TEM micrographs show spherical nanoparticles, the size and size distribution of which depends on the initial experimental conditions of temperature, time, water concentration, and tin precursor concentration. Nanoparticles of 19 nm median size and displaying a narrow size distribution have been obtained with excellent yield in the optimized conditions. HRTEM, XPS, XRD and Mossbauer studies indicate the composite nature of the particles that consist of a well-crystallized tin beta core of approximately equals 11 nm covered with a layer of approximately equals 4 nm of amorphous tin dioxide and which also contain quadratic tin monoxide crystallites. The thermal oxidation of this nanocomposite yields well-crystallized nanoparticles of SnO2* without coalescence or size change. XRD patterns show that the powder consists of a mixture of two phases: the tetragonal cassiterite phase, which is the most abundant, and an orthorhombic phase. In agreement with the small SnO2 particle size, the relative intensity of the adsorbed dioxygen peak observed on the XPS spectrum is remarkable, when compared with that observed in the case of larger SnO2 particles. This is consistent with electrical conductivity measurements, which demonstrate that this material is highly sensitive to the presence of a reducing gas such as carbon monoxide.

Rapid relaxation times measurements by MRI: an in vivo application to contrast agent modeling for muscle fiber types characterization.

This paper is a description of a simulation method to evaluate the contrast in NMR imaging and its aim is to help to optimize the use of contrast media in clinical imaging. Indeed, there is a need to define objective criteria in order to choose among several contrast media the ones that are the most effective and to define their optimal conditions of use, such as: the dose to be injected, the required time after injection to obtain the best enhancement and the optimal imaging sequence parameter values. The method is based on NMR signal simulation in the presence of contrast media and requires the fast measurement of the T1 and T2 relaxation times to obtain the dynamic relaxometry variation of tissues after contrast injection. In this work the fast imaging techniques that are to be described enable the measurement of T1 and T2 with a 30sec temporal resolution on 128*256 matrix images. The accuracy of the method was assessed in rabbit muscles after the injection of two gadolinium chelates (Gd-DTPA and Gd-DOTA) with the aim of improving the in vivo characterization of fast-twitch and slow-twitch muscle fiber types. The simulation results were in close agreement with contrast image analysis and showed, for relevant clinical doses, a small efficacy for both chelates. The interest of the proposed simulation method lies in the fact that it enables to objectively compare the efficacy of different contrast agents, to forecast the efficacy of a given contrast reagent and to define the optimal dose and the optimal imaging sequence parameters that give the best contrast. This simulation method obviates numerous prior experiments to evaluate the benefit expected from different contrast media. The method, which has been evaluated here for muscle investigations is applicable to any tissue analysis and can help to guide the best condition of use of contrast agents in MR imaging.